Healthcare Provider Details

I. General information

NPI: 1437649456
Provider Name (Legal Business Name): OPTUM INFUSION SERVICES 500, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2018
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 CHAPIN ROAD, BUILDING D, SUITE D7
PINE BROOK NJ
07058-9385
US

IV. Provider business mailing address

1 OPTUM CIR STE 100
EDEN PRAIRIE MN
55344-2956
US

V. Phone/Fax

Practice location:
  • Phone: 844-410-3647
  • Fax: 844-225-9055
Mailing address:
  • Phone: 800-328-5979
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DENISE MCCABE
Title or Position: SECRETARY
Credential:
Phone: 952-935-1191